[Interventions on facet joints. Techniques of facet joint injection, medial branch block and radiofrequency ablation].

Fluoroscopy-guided interventions on facet joints have been used for decades for the symptomatic management of pain in spinal disorders. A large number of imaging techniques are used to achieve a precise and safe needle placement in interventional procedures. Pulsed fluoroscopy is one of the most widely used and well-accepted tools for these procedures.

[Imaging-guided injection techniques of the lumbar spine].

Spinal injections are an important treatment option in the conservative management of many spinal disorders. A large number of imaging techniques are available to achieve a precise and safe needle placement in interventional procedures. Fluoroscopy-guided injections are safe, cost effective and available in most institutions.

Prevalence of sleep deprivation in patients with chronic neck and back pain: a retrospective evaluation of 1016 patients.

Background: Chronic low back pain (CLBP) and chronic neck pain (CNP) have become a serious medical and socioeconomic problem in recent decades. Patients suffering from chronic pain seem to have a higher prevalence of sleep disorders.

Purpose: To calculate the prevalence of sleep deprivation in patients with CLBP and CNP and to evaluate the factors that may contribute to sleep impairment.

[Prevalence of mental disorders in multimodal therapy of chronic back pain].

Because of its biopsychosocial factors chronic back pain is often resistant to unimodal therapy regimes. Multimodal pain programs are a promising therapy option in the management of chronic pain as they focus on functional restoration. The aim of the study was to evaluate the prevalence of psychopathology in patients with chronic back pain.

[Injection techniques in the cervical spine].

Spinal injections are a treatment option in the conservative management of degenerative spinal disorders. The indications must be critically reviewed for every patient. Treatment with injections for painful spinal disorders should be a part of interdisciplinary treatment regimes.

Radiation dose reduction in CT-guided sacroiliac joint injections to levels of pulsed fluoroscopy: a comparative study with technical considerations.

Background: The sacroiliac (SI) joint is frequently the primary source of low back pain. Over the past decades, a number of different SI injection techniques have been used in its diagnosis and therapy. Despite the concerns regarding exposure to radiation, image-guided injection techniques are the preferred method to achieve safe and precise intra-articular needle placement.

Effective Dose of CT-Guided Epidural and Periradicular Injections of the Lumbar Spine: A Retrospective Study.

Spinal injection procedures can be performed blindly or, more accurately, with fluoroscopic or computed tomography (CT) guidance. Radiographic guidance for selective nerve root blocks and epidural injections allows an accurate needle placement, reduces the procedure time and is more secure for the patient, especially in patients with marked degenerative changes and scoliosis, resulting in a narrowing of the interlaminar space. Limiting factors remain the availability of scanners and the radiation dose.

Radiation dose reduction in CT-guided periradicular injections in lumbar spine: Feasibility of a new institutional protocol for improved patient safety.

Background: Image guided spinal injections are successfully used in the management of low back pain and sciatica. The main benefit of CT-guided injections is the safe, fast and precise needle placement, but the radiation exposure remains a serious concern. The purpose of the study was to test a new institutional low-dose protocol for CT-guided periradicular injections in lumbar spine to reduce radiation exposure while increasing accuracy and safety for the patients.

Does the diagnosis influence the outcome in a multimodal outpatient pain management program for low back pain and sciatica? A comparative study.

The literature describes multimodal pain-management programs as successful therapy options in the conservative treatment of chronic low back pain. Yet, the intensity and inclusion criteria of such programs remain debatable. In many studies, the pain originating from spinal structures is described as nonspecific low back pain - a diffuse diagnosis without serious implications.

Intensive interdisciplinary outpatient pain management program for chronic back pain: a pilot study.

Background: Chronic back pain is relatively resistant to unimodal therapy regimes. The aim of this study was to introduce and evaluate the short-term outcome of a three-week intensive multidisciplinary outpatient program for patients with back pain and sciatica, measured according to decrease of functional impairment and pain.

Methods: The program was designed for patients suffering from chronic back pain to provide intensive interdisciplinary therapy in an outpatient setting, consisting of interventional injection techniques, medication, exercise therapy, back education, ergotherapy, traction, massage therapy, medical training, transcutaneous electrical nerve stimulation, aquatraining, and relaxation.

Effective radiation dose reduction in computed tomography-guided spinal injections: a prospective, comparative study with technical considerations.

Despite the good general patient acceptance, high patient comfort, safety and precision in the needle placement, exposure to radiation in computed tomography (CT)-guided spinal interventions remains a serious concern, and is often used to argue against its use. The aim of this study was to determine the technical possibilities of reducing the radiation dose in CT-guided epidural and periradicular injections in lumbar spine. We evaluated the possibilities of reducing radiation dose to the patient and operator during CT-guided injections on the lumbar spine using the following steps: significant reduction of the tube current and energy used for the topogram-acquisition, narrowing the area of interest in spiral CT-mode and reduction of tube current and radiation energy in the final intervention mode.

[Diffuse idiopathic skeletal hyperostosis: current aspects of diagnostics and therapy].

Diffuse idiopathic skeletal hyperostosis (DISH) is a common but often unrecognized systemic disorder observed mainly in the middle-aged and elderly population, characterized by ankylosing formations of the spine and ossifications of peripheral ligaments, tendons and joint capsule insertion points (entheses). Despite the increase of prevalence with age, the condition often remains undiagnosed. It can be an asymptomatic incidental radiographic finding but can also manifest in several multiorgan complications, such as back and neck pain, restriction of mobility of the spine, peripheral joint affection, dysphagia, dyspnea, foreign body sensation, hoarseness, neurologic manifestations due to compression of the spinal cord, hyperuricemia, obesity, hypercholesterinemia and resulting cardiovascular comorbidities, implicating a multidisciplinary approach.

[Spinal epidural lipomatosis].

Spinal epidural lipomatosis (SEL) is a rare condition affecting the thoracic and lumbar spine, characterized by a hypertrophy and hyperplasia of the rich vascularized fat tissue inside the spinal canal. The etiology of SEL is unknown. A high number of cases are associated with obesity, corticosteroid intake and a dysbalance in adrenocorticotropic hormone (ACTH)-cortisone metabolism.

Sciatica and incomplete paraplegia after spontaneous haematoma of the spinal cord due to a cumarine - induced coagulopathy: case report.

Spontaneous spinal haematoma is a rare cause of sciatica. We present a case of a 73 year old patient, who was admitted to our department and suffered from spontaneous sciatica over 24 hours. During the examination, the patient presented undulating symptoms of paraplegia, varying from incomplete loss of power in the left lower limb to complete plegia.

[Diabetes and Pregnancy (author's transl)].

Unlabelled: The article reports on the experiences collected during treatment and delivery of 316 pregnant diabetic women hospitalized in the municipal hospital of Vienna-Lainz. 1. Close co-operation between diabetologist, obstetricians and pediatricians in imperative.

[Diabetes and pregnancy: treatment and results (author's transl)].

Pregnancy and delivery in 190 diabetic women are described. Obstetric, medical and neonatal guidelines for treatment are outlined and the following results are reported: 1. The delivery dates suggested by P.

[Human placental lactogen and chorionic gonadotropin in diabetic pregnancies (author's transl)].

Serial determinations of serum HPL and HCG levels were carried out in 68 diabetic women during the whole course of pregnancy. In diabetic pregnancies of the type B--D according to White's classification, HPL levels were significantly lower than control values from the 10th to the 22nd week. In diabetic pregnancies of the type White A, HPL levels were significantly lower than the normal controls at the 10th and the 38th week, otherwise there was no significant difference between the two groups.

The effects of methylphenidate on the handwriting of children with minimal brain dysfunction.

Fifty children with minimal brain dysfunction who had handwriting deficits received methylphenidate or placebo under double-blind conditions. Twenty-six children (52%) showed improvement in hand-writing following treatment with methylphenidate for four weeks. One child receiving placebo had improvement in handwriting, but his handwriting improved further after he was switched to methylphenidate.